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da Fonte JBM, Fontenele RC, Farias-Gomes A, Ruiz DC, Andrade-Bortoletto MFS, Sousa Melo SL, Freitas DQ. Do the number of zirconia implants and the thickness of CBCT image reconstruction affect the detection of peri-implant bone defect? A diagnostic accuracy ex vivo study. Clin Oral Implants Res 2024. [PMID: 39072795 DOI: 10.1111/clr.14336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/12/2024] [Accepted: 07/09/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES To evaluate the influence of multiplanar reconstruction thickness on the detection of peri-implant bone defects with a standalone zirconia implant and compare it to when another implant is in the vicinity using cone-beam computed tomography (CBCT). MATERIALS AND METHODS Five dry human mandibles were used to create twenty implant sites in the second premolar and first molar regions. The OP300 Maxio was used to acquire CBCT images (90 kVp, 6.3 mA, 5 × 5 cm FOV, and 0.125 mm3 voxel size) before and after creating 3 mm peri-implant bone defects in the buccal aspect of the premolar region. Half of the scans featured a single zirconia implant in the premolar region, while the others had two implants in the premolar and molar regions. Three reconstruction thicknesses (0.125 mm, 1 mm, and 2 mm) were considered for the multiplanar reconstruction analyses. Five oral and maxillofacial radiologists assessed the detection of peri-implant bone defects using a 5-point scale. Diagnostic parameters were calculated and compared using Two-way ANOVA (α = .05). RESULTS The studied factors showed no significant influence on the diagnosis of peri-implant bone defects (p > .05). Diagnostic performance was notably higher with a single implant, especially with a 2-mm reconstruction thickness (AUC = 0.88, sensitivity = 0.68, specificity = 0.94). Although the differences were not statistically significant, the results were more modest when two implants were present (AUC = 0.80, sensitivity = 0.58, specificity = 0.82). CONCLUSIONS The presence of an adjacent zirconia implant and variations in reconstruction thickness did not influence the detection of 3 mm buccal peri-implant bone defects on CBCT images.
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Affiliation(s)
- Juliana Batista Melo da Fonte
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Department of Oral and Maxillofacial Diagnostic Sciences, School of Dental Medicine, University of Connecticut, Farmington, Connecticut, USA
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Amanda Farias-Gomes
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Débora Costa Ruiz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Saulo L Sousa Melo
- Department of Oral and Craniofacial Sciences, School of Dentistry, Oregon Health & Science University, Portland, Oregon, USA
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Gonzalez-Passos T, Barros-Costa M, Oliveira ML, Freitas DQ. Influence of tube current and metal artifact reduction on the diagnosis of external cervical resorption in teeth adjacent to a dental implant in CBCT: an ex-vivo study. Clin Oral Investig 2024; 28:356. [PMID: 38834721 DOI: 10.1007/s00784-024-05750-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 05/27/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVES This ex-vivo study aimed to assess the influence of tube current (mA) and metal artifact reduction (MAR) on the diagnosis of early external cervical resorption (EECR) in cone-beam computed tomography (CBCT) in the presence of an adjacent dental implant. MATERIALS AND METHODS Twenty-three single-rooted teeth were sectioned longitudinally and EECR was induced using a spherical drill and 5% nitric acid in 10 teeth. Each tooth was positioned in the socket of the lower right canine of a dry human mandible and CBCT scans were acquired using 90 kVp, voxel of 0.085 mm, field of view of 5 x 5 cm, and varying tube current (4, 8 or 12 mA), MAR (enabled or disabled) and implant conditions (with a zirconia implant in the socket of the lower right first premolar or without). Five oral radiologists evaluated the presence of EECR in a 5-point scale and the diagnostic values (area under the receiver operating characteristic curve - AUC, sensitivity, and specificity) were compared using multi-way Analysis of Variance (α = 0.05). Kappa test assessed intra-/inter-evaluator agreement. RESULTS The tube current only influenced the AUC values in the presence of the implant and when MAR disabled; in this case, 8 mA showed lower values (p<0.007). MAR did not influence the diagnostic values (p>0.05). In general, the presence of an implant reduced the AUC values (p<0.0001); sensitivity values with 8 mA and MAR disabled, and specificity values with 4 mA and MAR enabled and 8 mA regardless MAR were also decreased (p<0.0001). CONCLUSIONS Variations in tube current and MAR were unable to improve EECR detection, which was impaired by the presence of an adjacent implant. CLINICAL RELEVANCE Increasing tube current or activating MAR tool does not improve EECR diagnosis, which is hampered by the artifacts generated by dental implants.
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Affiliation(s)
- Thamiles Gonzalez-Passos
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil. Av. Limeira, 901, Zip Code13414903, Piracicaba, São Paulo, Brazil.
| | - Matheus Barros-Costa
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil. Av. Limeira, 901, Zip Code13414903, Piracicaba, São Paulo, Brazil
| | - Matheus L Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil. Av. Limeira, 901, Zip Code13414903, Piracicaba, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil. Av. Limeira, 901, Zip Code13414903, Piracicaba, São Paulo, Brazil
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Barros-Costa M, Barros-Candido JR, Sampaio-Oliveira M, Freitas DQ, Sverzut AT, Oliveira ML. Impact of the spatial orientation of the patient's head, metal artifact reduction, and tube current on cone-beam computed tomography artifact expression adjacent to a dental implant: A laboratory study using a simulated surgical guide. Imaging Sci Dent 2024; 54:191-199. [PMID: 38948193 PMCID: PMC11211021 DOI: 10.5624/isd.20240016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 07/02/2024] Open
Abstract
Purpose The aim of this study was to evaluate image artifacts in the vicinity of dental implants in cone-beam computed tomography (CBCT) scans obtained with different spatial orientations, tube current levels, and metal artifact reduction algorithm (MAR) conditions. Materials and Methods One dental implant and 2 tubes filled with a radiopaque solution were placed in the posterior region of a mandible using a surgical guide to ensure parallel alignment. CBCT scans were acquired with the mandible in 2 spatial orientations in relation to the X-ray projection plane (standard and modified) at 3 tube current levels: 5, 8, and 11 mA. CBCT scans were repeated without the implant and were reconstructed with and without MAR. The mean voxel and noise values of each tube were obtained and compared using multi-way analysis of variance and the Tukey test (α=0.05). Results Mean voxel values were significantly higher and noise values were significantly lower in the modified orientation than in the standard orientation (P<0.05). MAR activation and tube current levels did not show significant differences in most cases of the modified spatial orientation and in the absence of the dental implant (P>0.05). Conclusion Modifying the spatial orientation of the head increased brightness and reduced spatial orientation noise in adjacent regions of a dental implant, with no influence from the tube current level and MAR.
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Affiliation(s)
- Matheus Barros-Costa
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Julia Ramos Barros-Candido
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Matheus Sampaio-Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Alexander Tadeu Sverzut
- Division of Oral and Maxillofacial Surgery, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Bastos MF, Visconti MA, Pinto RR, Junqueira RB, Verner FS. Assessing the Impact of the Metal Artifact Reduction Tool on Detecting Furcation Lesions in Maxillary Molars with Different Intracanal Posts: An Ex Vivo Cone-beam Computed Tomography Study. J Endod 2024; 50:835-843. [PMID: 38395388 DOI: 10.1016/j.joen.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Considering the potential image compromise and diagnostic challenges posed by metals, this study aimed to assess the efficacy of the metal artifact reduction (MAR) tool in cone-beam computed tomography examinations for detecting furcation lesions in upper molars treated endodontically and restored with different intracanal posts. METHODS This ex vivo study used 45 endodontically treated maxillary first molars, categorized into the following3 groups (n = 15): control (without intracanal post), metal post, and fiberglass post. Simulations were conducted in the laboratory to replicate alveolar bone, periodontal ligament, and grade I, II, and III furcation lesions. Cone-beam computed tomography scans were obtained with and without the MAR tool, and the furcation lesions were evaluated considering a 5-point Likert scale. Data were analyzed at 5%. RESULTS In the control group, there was no influence of MAR (P > .05); grade II lesions were not diagnosed, and grade III lesions were the most detected (P < .05). In the metal post group with MAR, grade III lesions were diagnosed more frequently than I and II (P < .05) and grade III without MAR (P < .05). In the fiberglass post group, the diagnosis of grade I lesions decreased with MAR (P < .05), and without MAR, grade III was most diagnosed (P < .05); grade III lesions were the most diagnosed (P < .05). CONCLUSIONS The MAR tool was only effective for diagnosing grade III furcation lesions, regardless of the intracanal material. Its application for grade I and II lesions did not contribute to improved diagnosis. Furthermore, in the fiberglass post group with grade I lesions, the MAR tool negatively affected the detection of the lesions.
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Affiliation(s)
- Mayara Fidelis Bastos
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Augusta Visconti
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rocha Pinto
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Binato Junqueira
- Department of Dentistry, Federal University of Juiz de Fora/GV Campus, Governador Valadares, Brazil
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Capel CP, da Motta RJG, Pauwels R, Gaêta-Araujo H, Oliveira-Santos C, Tirapelli C. Effect of metal artefact reduction level on the assessment of dental implant positioning by cone-beam computed tomography. Dentomaxillofac Radiol 2024; 53:233-239. [PMID: 38466923 PMCID: PMC11056797 DOI: 10.1093/dmfr/twae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVES This study evaluated the effect of metal artefact reduction (MAR) level and tube current on the assessment of dental implant positioning relative to the mandibular canal (MC) through cone-beam computed tomography (CBCT). METHODS Titanium dental implants were placed in dried mandibles at 0.5-mm superior to the MC (group 1/n = 8) and 0.5-mm inside the MC with perforation of the cortex (group 2/n = 10). CBCT scans were obtained with different levels of MAR (off, medium, and high) and 2 tube currents (4 and 8 mA). Four examiners analysed the images and scored the contact between the implant and the MC using a 5-point scale. Sensitivity, specificity, area under receiver operating characteristic curve (ROC), and frequency of scores were calculated. Data were compared with analysis of variance 2-way and Tukey's test and scores with Chi-square test. RESULTS Specificity and area under ROC curve decreased significantly when MAR level was high compared with MAR-medium and MAR-off. The frequency of score 3 (inconclusive) was the highest, and scores 1 and 5 (definitely no contact and definitely contact, respectively) were the lowest with MAR-high, regardless of the tube current. When MAR was off, there were higher frequencies of scores 1 and 5. CONCLUSIONS The level of MAR influences the assessment of the relationship between the dental implant and the MC. MAR-high led to lower diagnostic accuracy compared with MAR-medium and off. ADVANCES IN KNOWLEDGE This article shows that high level of MAR can interfere in the diagnostic of dental implant positioning relative to the MC, decreasing its accuracy.
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Affiliation(s)
- Camila Porto Capel
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
| | - Raphael Jurca Gonçalves da Motta
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
| | - Ruben Pauwels
- Department of Dentistry and Oral Health, Aarhus University, 8000 Aarhus, Denmark
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, 10330 Bangkok, Thailand
| | - Hugo Gaêta-Araujo
- Department of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Diagnosis & Oral Health, University of Louisville, School of Dentistry, 40202-1701, Louisville, KY, United States
| | - Camila Tirapelli
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
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Rong R, Lv H, Sa Y. Single scanning of CBCT and intraoral scanning for guided implantation in terminal dentitions with multi-unit metal restorations: technical note. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101784. [PMID: 38286218 DOI: 10.1016/j.jormas.2024.101784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/12/2023] [Accepted: 01/24/2024] [Indexed: 01/31/2024]
Abstract
When anatomical landmarks are missing or obstructed by metal artefacts, it is challenging to accurately merge cone beam computed tomography (CBCT) and intraoral scanning (IOS) information, and the accuracy of the implant surgical guides would be compromised. This article describes a novel technical note using oral wound dressings and flowable resin as additional new radiopaque fiducial landmarks to design surgical guides for full-arch immediate implant placement. This technical note provided an accurate, convenient, and cost-effective option for the clinician.
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Affiliation(s)
- Rong Rong
- Department of Prosthodontics, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Present Address, Department of Implantology, Jinan Stomatological Hospital, Jinan, PR China
| | | | - Yue Sa
- Department of Prosthodontics, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China.
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Kuusisto N, Abushahba F, Syrjänen S, Huumonen S, Vallittu P, Närhi T. Zirconia implants interfere with the evaluation of peri-implant bone defects in cone beam computed tomography (CBCT) images even with artifact reduction, a pilot study. Dentomaxillofac Radiol 2023; 52:20230252. [PMID: 37641961 DOI: 10.1259/dmfr.20230252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Three-dimensional cone beam computed tomography (CBCT) imaging can be considered, especially in patients with complicated peri-implantitis (PI). Artifacts induced by dense materials are the drawback of CBCT imaging and the peri-implant bone condition may not be assessed reliably because the artifacts are present in the same area. This pilot study investigates the performance of the artifact reduction algorithm (ARA) of the Planmeca Viso G7 CBCT device (Planmeca, Helsinki, Finland) with three different implant materials and imaging parameters. METHODS Three pairs of dental implants consisting of titanium, zirconia, and fiber reinforced composite (FRC) were set into a pig mandible. A vertical defect simulating peri-implantitis bone loss was made on the buccal side of one of each implant. The defect was identified and measured by two observers and compared to the actual dimensions. In addition, the bone structure and the marginal cortex visibility between the implants were estimated visually. RESULTS The bone defect and its dimensions with the zirconia implant could not be identified in any image with or without the metal artifact reduction algorithm. The bone defect of titanium and FRC implants were identified with all three imaging parameters or even without ARA. The interobserver agreement between the two observers was almost perfect for all categories analyzed. CONCLUSION Peri-implantitis defect of the zirconia implant and the peri-implant bone structure of the zirconia implants cannot be recognized reliably with any ARA levels, or any imaging parameters used with the Planmeca Viso G7. The need for ARA when imaging the peri-implant bone condition of the titanium and FRC implants may be unnecessary.
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Affiliation(s)
- Niina Kuusisto
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Radiology, Päijät-Häme Central Hospital, Lahti, Finland
| | - Faleh Abushahba
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Stina Syrjänen
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Sisko Huumonen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Pekka Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Turku, Finland
- Welfare Division, City of Turku, Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
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Cascante-Sequeira D, Fontenele RC, Martins LAC, Brasil DM, Oliveira ML, Freitas DQ, Haiter-Neto F. Does the shape of the field-of-view influence the magnitude of artefacts from high-density materials in cone-beam computed tomography? Dentomaxillofac Radiol 2023; 52:20230147. [PMID: 37493606 PMCID: PMC10552126 DOI: 10.1259/dmfr.20230147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE To compare cylindrical and convex triangular field-of-views (FOVs) concerning the magnitude of artefacts from high-density materials in cone-beam CT (CBCT). METHODS AND MATERIALS Cylinders of amalgam, chromium-cobalt, titanium, and zirconia were individually placed in the anterior and posterior regions of a polymethylmethacrylate phantom and scanned using cylindrical and convex triangular FOVs of the Veraview X800 CBCT device. Using the Image J software, 15 square regions of interest (ROIs) were placed in the axial reconstruction around the middle level of the cylinder and at distances of 0.5, 1.0, and 1.5 cm from the centre of the cylinder. Mean grey value and standard deviation of each ROI were averaged for each distance and subtracted from the values of a control ROI to calculate the magnitude of the artefacts by the grey value mean difference (GVMD) and grey value standard deviation (GVSD). Multiway analysis of variance with Tukey post-hoc test with a significance level of 5% evaluated the effect of the shape of the FOV, position inside the FOV, high-density material, and the distance of the artefact from the material. RESULTS The convex triangular FOV increased the GVSD for all materials in the anterior and posterior regions at 0.5 cm compared to the cylindrical FOV (p < 0.0001). The convex triangular FOV showed greater GVMD for chromium-cobalt and zirconium in the anterior region and all materials in the posterior region at all distances (p < 0.0001). CONCLUSION The FOV shape influences the magnitude of artefacts from high-density materials. The convex triangular FOV showed greater artefact magnitude with variability among the high-density materials, region in the FOV, and distance from the material.
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Affiliation(s)
- Deivi Cascante-Sequeira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Luciano Augusto Cano Martins
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Danieli Moura Brasil
- Department of Oral Diagnosis & Oral Health, University of Louisville School of Dentistry, Louisville, United States of America
| | - Matheus L Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Asnaashari M, Sadeghipour M, Bahrani Z, Valizadeh S, Moshfeghi M. The Effect of Changes in the Angular Position of Implants on Metal Artifact Reduction in Cone-Beam Computed Tomography Images: A Scoping Review. Radiol Res Pract 2023; 2023:5539719. [PMID: 37554657 PMCID: PMC10406552 DOI: 10.1155/2023/5539719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/07/2023] [Accepted: 07/20/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE Dental implant artifacts can compromise the quality of cone-beam computed tomography (CBCT) scans and challenge radiographic detection in surrounding regions. This literature review was conducted to examine the impact of implant angle modification on reducing metal artifacts in CBCT scans. MATERIALS AND METHODS A scoping review of literature was carried out in PubMed, Embase, Scopus, and Cochrane databases. RESULTS Different spatial planes, including alpha, beta, gamma, and phi, along with 0°, 5.2°, 9.8°, 14.5°, 15°, 30°, 45°, 60°, 75°, and 90° angles were studied. Changes in the angular position of implants may reduce metal artifacts and improve the quality of CBCT scans. CONCLUSIONS Rotating implants within the alpha plane and angling them at 90° in the alpha plane enables reducing dental implant artifacts.
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Affiliation(s)
- Maedeh Asnaashari
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Sadeghipour
- Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Bahrani
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Solmaz Valizadeh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahkameh Moshfeghi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sutare A, Parihar A, Reddy P, Singh R, Ac V. Influence of Windowing and Evaluation of Metal Artifact Reduction Algorithm on Five Different Restorative Materials by Using Different Cone Beam Computed Tomography (CBCT) Scanners: A CBCT Study. Cureus 2023; 15:e41742. [PMID: 37575712 PMCID: PMC10415591 DOI: 10.7759/cureus.41742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
OBJECTIVES To assess the influence of windowing, and to evaluate, and compare the effect of the metal artifact reduction (MAR) and non-metal artifact reduction (non-MAR) algorithms on different high-density restorative dental materials using different cone beam computed tomography (CBCT) devices. MATERIAL AND METHOD Height and diameter of all cylindrical shape metals including amalgam, cobalt-chromium, composite, gutta-percha, and titanium were measured using a digital caliper device. Polymethylmethacrylate block and arch phantom with a cylindrical-shaped perforation containing five different metals were submitted to tomographic acquisition with six different cone beam computed tomographic devices in small fields of view with their MAR enabled and disabled. Windowing was done using ITK-SNAP software (3.8.2) which was used as a contrast medial tool for window level and window width. The data was analyzed for probability distribution using the Kolmogorov-Smirnov test, where a p-value of <0.05 indicated that the data were not normally distributed. The comparison of length and width was done using the Wilcoxon sign rank test. Comparison of categorical variables was done using the Chi-square test where a p-value of <0.05 was considered statistically significant. RESULTS Length and width of all these metals measured using MAR and non-MAR CBCT were found to be statistically non-significant (p-value of >0.05). MAR algorithm significantly reduces metals artifact produced by high-density restorative materials (p-value of <0.05). CONCLUSION Amalgam and cobalt-chromium produced more artifacts while composite and gutta-percha did not produce enough artifacts to be reduced by the MAR algorithm. Large window width and high window level would be beneficial to reduce the metal artifact.
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Affiliation(s)
- Ajay Sutare
- Department of Oral Medicine and Radiology, Government College of Dentistry Indore, Indore, IND
| | - Ajay Parihar
- Department of Oral Medicine and Radiology, Government College of Dentistry Indore, Indore, IND
| | - Prashanthi Reddy
- Department of Oral Medicine and Radiology, Government College of Dentistry Indore, Indore, IND
| | - Renu Singh
- Department of Oral Medicine and Radiology, Government College of Dentistry Indore, Indore, IND
| | - Varsha Ac
- Department of Oral Medicine and Radiology, Government College of Dentistry Indore, Indore, IND
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Almeshari A, Abdelkarim AZ, Geha H, Khan AA, Ruparel N. Assessing the Efficacy of Planmeca ProMax® 3D Cone-Beam CT Machine in the Detection of Root Fractures With Varied Metal Artifact Reduction Settings and Three Kilovoltage Peak Levels. Cureus 2023; 15:e35647. [PMID: 37009371 PMCID: PMC10065128 DOI: 10.7759/cureus.35647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND This study aims to examine the accuracy of cone-beam computed tomography (CBCT) machines in detecting root fracture when using different metal artifact reduction (MAR) settings at different kilovoltage peak (kVp) levels. METHODOLOGY Sixty-six tooth roots were treated endodontically using a standardized technique. Of these, 33 roots were randomly selected to be fractured; the other 33 roots were intact and used as controls. The roots were placed randomly in prepared beef ribs to mimic the alveolar bone. Imaging was performed by Planmeca ProMax® 3D (Planmeca, Helsinki, Finland) using different MAR settings (no, low, mid, and high) at three different levels of kVp: 70, 80, and 90. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated. RESULTS There was a significant difference in accuracy when using different MAR settings within the group of 70 kVp. Likewise, within the group of 90 kVp. There was no significant difference between different MAR settings at 80 kVp. Using low MAR/90 kVp had significantly higher accuracy relative to other MAR settings at 90 kVp; it also had the highest values of sensitivity, specificity, and AUC in the study. Using mid and high MAR at 70 kVp or 90 kVp decreased accuracy significantly. Mid MAR/90 kVp was the least effective setting in this study. CONCLUSIONS Using low MAR at 90 kVp significantly increased the accuracy within the group of 90 kVp. In contrast, mid MAR and high MAR in 70 and 90 kVp, respectively, decreased accuracy significantly.
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Nomier AS, Gaweesh YSED, Taalab MR, El Sadat SA. Efficacy of low-dose cone beam computed tomography and metal artifact reduction tool for assessment of peri-implant bone defects: an in vitro study. BMC Oral Health 2022; 22:615. [PMID: 36528573 PMCID: PMC9759909 DOI: 10.1186/s12903-022-02663-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Early accurate radiographic assessment of peri-implant bone condition is highly important to avoid excessive loss of supporting bone and implant failure. Cone beam computed tomography (CBCT) is the radiographic technique of choice if peri-implant dehiscence and fenestration defects are suspected. The higher radiation dose and the presence of beam hardening artifacts are the main drawbacks of CBCT imaging techniques. This study aims to evaluate the influence of low-dose cone beam computed tomography (LD-CBCT) and metal artifact reduction (MAR) tool on the assessment of peri-implant dehiscence and fenestration. METHODOLOGY Thirty titanium implants were inserted into bovine rib blocks. Twenty had standardized bone defects (10 with dehiscence and 10 with fenestration), while the remaining 10 were used as control group with no defects. Radiographic examinations held with high-definition CBCT (HD-CBCT) and LD-CBCT with and without application of MAR tool. Images were assessed by four examiners for the presence or absence of peri-implant defects. The area under the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and accuracy were calculated for all radiographic protocols. RESULTS In the absence of MAR tool, there was no difference in AUC and diagnostic values between LD-CBCT and HD-CBCT for detection of both defects. When the MAR tool was applied, the AUC values, sensitivity, and accuracy were higher in HD-CBCT than in LD-CBCT for the detection of both defects, especially for the dehiscence, while specificity remained the same. CONCLUSION LD-CBCT can be used in the evaluation of peri-implant dehiscence and fenestration without any decrease in diagnostic accuracy. The application of MAR tool decrease the diagnostic ability of both defects, especially for the detection of dehiscence defects.
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Affiliation(s)
- Alaa Shafiek Nomier
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Yousria Salah El-Din Gaweesh
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Maha R. Taalab
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Shaimaa Abu El Sadat
- grid.7269.a0000 0004 0621 1570Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
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Sawicki P, Zawadzki PJ, Regulski P. The Impact of Cone-Beam Computed Tomography Exposure Parameters on Peri-Implant Artifacts: A Literature Review. Cureus 2022; 14:e23035. [PMID: 35419219 PMCID: PMC8994570 DOI: 10.7759/cureus.23035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 01/09/2023] Open
Abstract
Cone-beam computed tomography (CBCT) amounts to an excellent diagnostic tool to evaluate the peri-implant bone thickness in all dimensions. Despite the unquestionable advantages of CBCT, potential artifacts around dental implants might disturb the proper assessment of the surrounding structures. The artifacts may mask osseointegration, shallow bone defects, and other types of radiolucency, which make it difficult to establish an early diagnosis of bone loss. Proper diagnosis of bone defect is necessary to decide about surgical intervention. The aim of this literature review is to assess the CBCT exposure causing artifacts on the peri-implant structures. An electronic search of MEDLINE (PubMed) database includes studies published before July 2021 and supplemented by manual research. Clinical, ex vivo, in vitro, and animal studies evaluating the relationship between exposition parameters and occurrence of artifacts around the dental implant in CBCT studies were included. A literature review revealed that kilovoltage, tube current, and field of view may affect the occurrence of artifacts around dental implants, all of which would compromise radiological evaluation. Therefore, it is feasible to reduce the incidence of artifacts and improve the image quality by appropriate modification of the exposure parameters. However, the reduction of artifacts is often associated with a significant increase in radiation exposure; hence, an effort should be made to minimize the radiation dose in line with the ALARA (as low as reasonably achievable) principle.
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Affiliation(s)
- Paweł Sawicki
- Department of Cranio-Maxillofacial Surgery, Oral Surgery, and Implantology, Medical University of Warsaw, Warsaw, POL
| | - Paweł J Zawadzki
- Department of Cranio-Maxillofacial Surgery, Oral Surgery, and Implantology, Medical University of Warsaw, Warsaw, POL
| | - Piotr Regulski
- Department of Dental and Maxillofacial Radiology, Medical University of Warsaw, Warsaw, POL.,Center of Digital Science and Technology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, POL
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Demirturk Kocasarac H, Koenig LJ, Ustaoglu G, Oliveira ML, Freitas DQ. CBCT image artefacts generated by implants located inside the field of view or in the exomass. Dentomaxillofac Radiol 2022; 51:20210092. [PMID: 34289314 PMCID: PMC8802698 DOI: 10.1259/dmfr.20210092] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To compare artefacts in cone-beam computed tomography (CBCT) arising from implants of different materials located either inside the field of view (FOV) or in the exomass, and to test different image-acquisition parameters to reduce them. METHODS CBCT scans of a human mandible prepared with either a titanium, titanium-zirconium, or zirconia implant were acquired with the Planmeca ProMax utilizing FOV sizes of 8 × 5 cm and 4 × 5 cm, which placed the implant inside the FOV (8 × 5 cm) or in the exomass (4 × 5 cm). The scanning parameters considered three conditions of metal artefact reduction (MAR), disabled, low, and high, and 2 kVp levels (80 and 90). The standard deviation (SD) of grey values of regions of interest was obtained. The effects of implant material, implant position, MAR condition, kVp level, and their interactions were evaluated by Analysis of Variance (α = 5%). RESULTS The zirconia implant produced the highest SD values (more heterogeneous grey values, corresponding to greater artefact expression), followed by titanium-zirconium, and titanium. In general, implants in the exomass produced images with higher SD values than implants inside the FOV. MAR was effective in decreasing SD values, especially from the zirconia implant, only when the implant was inside the FOV. Images with 80 kVp had higher SD values than those with 90 kVp, regardless of the other factors (p < 0.05). CONCLUSIONS Implants in the exomass lead to greater artefact expression than when they are inside the FOV. Special attention should be paid to scanning parameters that reduce metal-related artefacts, such as MAR activation and increasing kVp. This is especially important with a zirconia implant inside the FOV.
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Affiliation(s)
- Husniye Demirturk Kocasarac
- Division of Oral and Maxillofacial Radiology, Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, United States
| | - Lisa J Koenig
- Division of Oral and Maxillofacial Radiology, Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, United States
| | - Gulbahar Ustaoglu
- Department of Periodontics, Bolu Abant Izzet Baysal University Faculty of Dentistry, BAIBU Golkoy Yerleskesi, Merkez/Bolu, Turkey
| | - Matheus Lima Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Wang AHT, Panzarella FK, Fontana CE, Junqueira JLC, da Silveira Bueno CE. Effect of cone-beam computed tomography metal artefact reduction on incomplete subtle vertical root fractures. Imaging Sci Dent 2022; 53:11-19. [PMID: 37006793 PMCID: PMC10060756 DOI: 10.5624/isd.20220106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose This study compared the accuracy of detection of incomplete vertical root fractures (VRFs) in filled and unfilled teeth on cone-beam computed tomography images with and without a metal artefact reduction (MAR) algorithm. Materials and Methods Forty single-rooted maxillary premolars were selected and, after endodontic instrumentation, were categorized as unfilled teeth without fractures, filled teeth without fractures, unfilled teeth with fractures, or filled teeth with fractures. Each VRF was artificially created and confirmed by operative microscopy. The teeth were randomly arranged, and images were acquired with and without the MAR algorithm. The images were evaluated with OnDemand software (Cybermed Inc., Seoul, Korea). After training, 2 blinded observers each assessed the images for the presence and absence of VRFs 2 times separated by a 1-week interval. P-values<0.05 were considered to indicate significance. Results Of the 4 protocols, unfilled teeth analysed with the MAR algorithm had the highest accuracy of incomplete VRF diagnosis (0.65), while unfilled teeth reviewed without MAR were associated with the least accurate diagnosis (0.55). With MAR, an unfilled tooth with an incomplete VRF was 4 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition, while without MAR, an unfilled tooth with an incomplete VRF was 2.28 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition. Conclusion The use of the MAR algorithm increased the diagnostic accuracy in the detection of incomplete VRF on images of unfilled teeth.
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Affiliation(s)
- Andréa Huey Tsu Wang
- Division of Endodontics, Research Institute, São Leopoldo Mandic Dental School, Campinas, Brazil
| | - Francine Kühl Panzarella
- Division of Oral Radiology, Research Institute, São Leopoldo Mandic Dental School, Campinas, Brazil
| | - Carlos Eduardo Fontana
- Division of Endodontics, Centre for Health Sciences, Pontifical Catholic University of Campinas, Campinas, Brazil
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Barros de Oliveira ML, Junqueira RB, Kamburoğlu K, Eratam N, Çakmak EE, Sönmez G, Küçük Ö, Verner FS. Assessment of the Metal Artifact Reduction Tool for the Detection of Root Isthmus in Mandibular Molars with Intraradicular Posts in Cone-beam Computed Tomographic Scans. J Endod 2021; 47:1583-1591. [PMID: 34265325 DOI: 10.1016/j.joen.2021.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/21/2021] [Accepted: 07/03/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study evaluated the performance of the metal artifact reduction (MAR) tool in cone-beam computed tomographic scans using different fields of view (FOVs) in the detection of a root isthmus in mandibular molars with intraradicular posts. METHODS Twenty-eight teeth were scanned by micro-computed tomographic imaging (gold standard images). Thereafter, specimens were allocated into the following groups: gutta-percha (teeth without posts, n = 10), a prefabricated metal post (n = 9), and a fiberglass post (n = 9). Cone-beam computed tomographic scans were taken using 8 acquisition protocols, varying the size of the FOV (10 × 5.5 cm and 5 × 5.5 cm) and the MAR tool (disabled, low, normal, and high modes). A root isthmus was evaluated considering a 5-point scale. Data were analyzed considering a 5% significance level. RESULTS Intra- and interexaminer agreement varied from moderate to substantial. The frequency of correct diagnosis varied significantly in all groups regardless of the image acquisition protocol selected (P < .05). In the gutta-percha group, there was no difference in the accuracy, sensitivity, and specificity values between the tested protocols. In the metal and fiberglass post groups, the accuracy values were higher with the "disabled" and "low" modes of the MAR tool regardless of the FOV size. This was also observed for the sensitivity values in the metal post group (P < .05). CONCLUSIONS The size of the FOV did not affect the performance of the MAR tool in the diagnosis of a root isthmus in molars with intraradicular posts. Our findings suggest that the use of the tool in the "normal" and "high" modes is contraindicated for this purpose.
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Affiliation(s)
- Manuela Lima Barros de Oliveira
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Rafael Binato Junqueira
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil; Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | - Nejlan Eratam
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Esra Ece Çakmak
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Gül Sönmez
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Özlem Küçük
- Department of Nuclear Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Francielle Silvestre Verner
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil; Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
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Accuracy of digital model generated from CT data with metal artifact reduction algorithm. Sci Rep 2021; 11:10332. [PMID: 33990637 PMCID: PMC8121776 DOI: 10.1038/s41598-021-89298-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 04/22/2021] [Indexed: 11/08/2022] Open
Abstract
This study investigated whether metal artifact reduction (MAR) applied computed tomography (CT) scans could be used to generate precise digital models and explored possible correlations between the amount of metal artifact and model accuracy. Thirty maxillofacial CT scans were randomly selected and a MAR algorithm was applied. By subtracting the original and MAR-applied CT images, the amount of metal artifact was quantified. Digital models were generated from the original and the MAR-applied CT data. Paired digital models were superimposed and shape deviation in planar surface was measured at 10 points in 4 planes. Statistical analyses were performed to compare deviations and to assess correlations between the amount of artifact and deviation. The MAR algorithm reduced metal artifact in all cases. The overall mean deviation of the MAR-applied models was 0.0868 mm, with no significant difference according to the reference plane. The amount of artifact did not significantly influence the accuracy of the digital models. MAR-applied CT is a convenient source for digital modeling with clinically acceptable accuracy. The MAR algorithm can be used regardless of the amount of metal artifact, which are generated by dental prostheses, for the quick and convenient manipulation of dental digital models.
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18
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Oliveira MR, Sousa TO, Caetano AF, de Paiva RR, Valladares-Neto J, Yamamoto-Silva FP, Silva MAG. Influence of CBCT metal artifact reduction on vertical radicular fracture detection. Imaging Sci Dent 2021; 51:55-62. [PMID: 33828962 PMCID: PMC8007395 DOI: 10.5624/isd.20200191] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/17/2020] [Accepted: 11/24/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This study evaluated the influence of a metal artifact reduction (MAR) tool in a cone-beam computed tomography (CBCT) device on the diagnosis of vertical root fractures (VRFs) in teeth with different root filling materials. Materials and Methods Forty-five extracted human premolars were classified into three subgroups; 1) no filling; 2) gutta-percha; and 3) metallic post. CBCT images were acquired using an Orthopantomograph 300 unit with and without a MAR tool. Subsequently, the same teeth were fractured, and new CBCT scans were obtained with and without MAR. Two oral radiologists evaluated the images regarding the presence or absence of VRF. Receiver operating characteristic (ROC) curves and diagnostic tests were performed. Results The overall area under the curve values were 0.695 for CBCT with MAR and 0.789 for CBCT without MAR. The MAR tool negatively influenced the overall diagnosis of VRFs in all tested subgroups, with lower accuracy (0.45–0.72), sensitivity (0.6–0.67), and specificity (0.23–0.8) than were found for the images without MAR. In the latter group, the accuracy, sensitivity, and specificity values were 0.68–0.77, 0.67–083, and 0.53–087, respectively. However, no significant difference was found between images with and without MAR for the no filling and gutta-percha subgroups (P>0.05). In the metallic post subgroup, CBCT showed a significant difference according to MAR use (P<0.05). Conclusion The OP 300 MAR tool negatively influenced the detection of VRFs in teeth with no root canal filling, gutta-percha, or metallic posts. Teeth with metallic posts suffered the most from the negative impact of MAR.
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Affiliation(s)
- Mariana Rodrigues Oliveira
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Aline Ferreira Caetano
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Rogério Ribeiro de Paiva
- Department of Oral Radiology, School of Dentistry, Anápolis University Centre, Anápolis, Goiás, Brazil
| | - José Valladares-Neto
- Department of Oral Rehabilitation, Division of Orthodontics, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Maria Alves Garcia Silva
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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Mancini AXM, Santos MUC, Gaêta-Araujo H, Tirapelli C, Pauwels R, Oliveira-Santos C. Artefacts at different distances from titanium and zirconia implants in cone-beam computed tomography: effect of tube current and metal artefact reduction. Clin Oral Investig 2021; 25:5087-5094. [PMID: 33544197 DOI: 10.1007/s00784-021-03821-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/29/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the effect of cone-beam computed tomography (CBCT) tube current (mA) on the magnitude of artefacts at different distances from titanium or zirconia implants, with and without activation of a proprietary metal artefact reduction (MAR). MATERIAL AND METHODS Human mandibles were scanned on an OP300 Maxio CBCT unit (Instrumentarium, Tuusula, Finland) before and after the installation of dental implants, with four different tube currents (4 mA, 6.3 mA, 8 mA and 10 mA), with and without activation of proprietary MAR. The effect of mA on the standard deviation (SD) of gray values and contrast to noise ratio (CNR) were assessed in regions of interest located 1.5 cm, 2.5 cm, and 3.5 cm from implants. RESULTS In the presence of titanium implants, a significant decrease in SD was found by increasing tube current from 4 mA to 6.3 mA or 8 mA. For zirconia implants, 8 mA yielded better results for all distances. MAR improved CNR in the presence of zirconia implants at all distances, whereas no differences were observed with the use of MAR for titanium implants. CONCLUSION Increased tube current can improve overall image quality in the presence of implants, at all the distances tested. When a zirconia implant is present, such increase in mA should be higher in comparison to that for examinations with titanium implants. Activation of OP300 Maxio proprietary MAR improved image quality only among examinations with zirconia implants. CLINICAL RELEVANCE Artefact-generating implants are common in the field of view of CBCT examinations. Optimal exposure parameters, such as tube current, ensure high image quality with lowest possible radiation exposure.
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Affiliation(s)
- Arthur Xavier Maseti Mancini
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Av. Do Café, s/n, Ribeirao Preto, Sao Paulo, 14040-904, Brazil.
| | - Matheus Urias Cruz Santos
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Av. Do Café, s/n, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
| | - Hugo Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Camila Tirapelli
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Av. Do Café, s/n, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
| | - Ruben Pauwels
- Medical Physics & Quality Assessment, Department of Imaging & Pathology, Catholic University of Leuven, Leuven, Belgium and Aarhus Institute of Advanced Studies, Aarhus University, Høegh-Guldbergs Gade 6B, 8000, Aarhus, Denmark
| | - Christiano Oliveira-Santos
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Av. Do Café, s/n, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
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Moratin J, Berger M, Rückschloss T, Metzger K, Berger H, Gottsauner M, Engel M, Hoffmann J, Freudlsperger C, Ristow O. Head motion during cone-beam computed tomography: Analysis of frequency and influence on image quality. Imaging Sci Dent 2020; 50:227-236. [PMID: 33005580 PMCID: PMC7506095 DOI: 10.5624/isd.2020.50.3.227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/30/2020] [Accepted: 06/25/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose Image artifacts caused by patient motion cause problems in cone-beam computed tomography (CBCT) because they lead to distortion of the 3-dimensional reconstruction. This prospective study was performed to quantify patient movement during CBCT acquisition and its influence on image quality. Materials and Methods In total, 412 patients receiving CBCT imaging were equipped with a wireless head sensor system that detected inertial, gyroscopic, and magnetometric movements with 6 dimensions of freedom. The type and amplitude of movements during CBCT acquisition were evaluated and image quality was rated in 7 different anatomical regions of interest. For continuous variables, significance was calculated using the Student t-test. A linear regression model was applied to identify associations of the type and extent of motion with image quality scores. Kappa statistics were used to assess intra- and inter-rater agreement. Chi-square testing was used to analyze the impact of age and sex on head movement. Results All CBCT images were acquired in a 10-month period. In 24% of the investigations, movement was recorded (acceleration: >0.10 [m/s2]; angular velocity: >0.018 [°/s]). In all examined regions of interest, head motion during CBCT acquisition resulted in significant impairment of image quality (P<0.001). Movement in the horizontal and vertical axes was most relevant for image quality (R2>0.7). Conclusion Relevant head motions during CBCT imaging were frequently detected, leading to image quality loss and potentially impairing diagnosis and therapy planning. The presented data illustrate the need for digital correction algorithms and hardware to minimize motion artefacts in CBCT imaging.
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Affiliation(s)
- Julius Moratin
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Moritz Berger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Thomas Rückschloss
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Karl Metzger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Hannah Berger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Maximilian Gottsauner
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Germany
| | - Michael Engel
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | | | - Oliver Ristow
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
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